Trends, Characteristics, and Clinical Outcomes of Patients Undergoing Percutaneous Coronary Intervention in Korea between 2011 and 2015
Seungbong Han1, Gyung Min Park2, Yong Giun Kim3
1Department of Applied Statistics, Gachon University, Seongnam, Korea.
Insights
Percutaneous coronary intervention (PCI) for angina increased in Korea, while PCI for acute myocardial infarction slightly decreased. Healthcare strategies must adapt to these trends and patient characteristics.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Health Services Research
Background:
- Coronary artery disease (CAD) management involves percutaneous coronary intervention (PCI).
- Understanding nationwide trends in PCI is crucial for public health planning.
- Korean National Health Insurance claims data provide a valuable resource for analyzing large patient cohorts.
Purpose of the Study:
- To evaluate nationwide trends in percutaneous coronary intervention (PCI) utilization in Korea.
- To characterize patients undergoing PCI for coronary artery disease.
- To analyze clinical outcomes and healthcare costs associated with PCI.
Main Methods:
- Analysis of 81,115 patients undergoing first-time PCI for coronary artery disease from 2011-2015 using Korean National Health Insurance claims data.
- Patients were stratified into angina and acute myocardial infarction (AMI) groups.
- Evaluation of procedural devices, medications, costs, and in-hospital mortality.
Main Results:
- PCI for angina increased by 10% from 2011-2012 to 2014-2015, while PCI for AMI slightly decreased.
- Drug-eluting stents were the predominant device (93.2%).
- In-hospital mortality was 2.6%, with significant associated medical costs.
Conclusions:
- Significant shifts in PCI utilization for angina versus AMI were observed in Korea.
- Characterization of patient demographics, comorbidities, and treatment patterns is essential.
- Healthcare strategies require adaptation to evolving PCI trends and outcomes.
Background And Objectives:
We sought to evaluate nationwide trends, characteristics, and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) in Korea.
Methods:
From National Health Insurance claims data in Korea, 81,115 patients, who underwent PCI for the first episode of coronary artery disease between 2011 and 2015, were enrolled. Patients were categorized into angina (n=49,288) or acute myocardial infarction (AMI, n=31,887) groups and analyzed.
Results:
The mean age of patients was 64.4±12.2 years and 56,576 (69.7%) were men. Diabetes, hyperlipidemia, and hypertension were observed in 27,086 (33.4%), 30,675 (37.8%), and 45,389 (56.0%) patients, respectively. There was a 10% increase in the number of patients undergoing PCI for angina between 2011-2012 and 2014-2015 (11,105 vs. 13,261; p=0.021). However, the number of patients undergoing PCI for AMI marginally decreased between 2011-2012 and 2014-2015 (8,068 vs. 7,823; p=0.052). In procedures, drug-eluting stent was the most frequently used device (93.2%), followed by balloon angioplasty (5.5%) and bare metal stents (1.3%). The mean number of stents per patient was 1.39±0.64. At discharge, dual-anti platelet therapy, statin, beta-blockers, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker were provided to 76,292 (94.1%), 71,411 (88.0%), 57,429 (70.8%), and 54,418 (67.1%) patients, respectively. The mean in-hospital and 1-year total medical costs were 8,628,768±4,832,075 and 13,128,158±9,758,753 Korean Won, respectively. In-hospital mortality occurred in 2,094 patients (2.6%).
Conclusions:
Appropriate healthcare strategies reflecting trends, characteristics, and clinical outcomes of PCI are needed in Korea.
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